Prediction model, risk factor score and ventilator-associated pneumonia: A two-stage case-control study.

Area of Science:

• Critical Care Medicine
• Infectious Diseases
• Biostatistics

Background:

• Ventilator-associated pneumonia (VAP) is a significant hospital-acquired infection in mechanically ventilated patients.
• Effective tools for predicting and preventing VAP are currently limited.

Purpose of the Study:

• To develop and validate a weighted risk scoring system (RFS) for predicting VAP.
• To evaluate the diagnostic performance of the developed RFS.

Main Methods:

• A two-stage VAP case-control study was conducted.
• Prediction models (LASSO, RF, XGBoost) were used to identify significant VAP predictors.
• A weighted RFS was calculated and validated in independent cohorts.

Main Results:

• Key predictors for VAP included length of stay before MV, MV duration, surgery, tracheotomy, MDRO infection, CRP, PaO2, and APACHE II score.
• The RFS demonstrated a significant linear association with VAP risk (OR=2.699).
• The RFS showed excellent discrimination for VAP in both discovery (AUC=0.857) and validation (AUC=0.879) stages.

Conclusions:

• Multiple factors contribute to VAP risk.
• The proposed risk factor scoring system shows potential as a valuable clinical tool for VAP prevention.